Post-operative outcomes, including opioid utilization and length of stay, following total knee arthroplasty: A retrospective case matched series comparing conventional and robotic-assisted total knee arthroplasty

J. Pearson, Thomas J Schlierf, Kathy Zhang, Jeffrey T. Hodrick
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Abstract

Keywords Total Knee Arthroplasty, robotic-assisted, opioid use Background With the rise of robotic arm-assisted total knee arthroplasty (TKA) cases, there is a need to determine if there are clinical benefits associated with this technology. The purpose of this study was to further evaluate if robotic-assisted TKAs result in improved inpatient post-operative outcomes compared to conventional TKAs. Materials and Methods After IRB approval, a retrospective chart review of 100 robotic-assisted primary TKAs and 100 matched controls undergoing conventional TKA was performed. Patients underwent primary TKA from 2016 to 2018 with minimum 6-month postoperative follow-up by a single fellowship-trained arthroplasty surgeon at a high-volume joint center. Exclusion criteria included <6 month postoperative follow-up, incomplete chart information, inflammatory arthritis, and BMI >40. Demographics and post-operative outcomes, including length of stay (LOS), opioid consumption, duration of opioid use, and discharge status, were recorded. Results There were no significant differences in pre-operative demographics between the two groups. A decrease in LOS (1.58 vs. 2.18 days, p < 0.001) and morphine equivalents (73.52 vs. 102.50, p = 0.017) was reported for the robotic TKA group compared to the control group. The robotic group also reported fewer patients at six weeks postoperatively requiring opioids compared to the control group (37 vs. 61, p = 0.001). Average KOOS Jr at 6-months postoperatively was 81.73 for the control group and 78.22 in the robotic group (p = 0.039). Conclusion Robotic-assisted TKA patients experienced significantly decreased LOS, morphine equivalents, and opioid usage at 6-week postoperatively, indicating that there are early clinical benefits of robotic-assisted TKA. No significant differences between the robotic and control groups were reported in pre-operative KOOS Jr. Although average 6-month postoperative KOOS Jr was slightly higher for the control group, the difference was clinically insignificant. Our average KOOS Jr for both cohorts was higher than the national 1-year postoperative average, 76.8.
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全膝关节置换术后的术后结果,包括阿片类药物的使用和住院时间:回顾性的病例匹配系列比较传统和机器人辅助的全膝关节置换术
背景随着机械臂辅助全膝关节置换术(TKA)病例的增加,有必要确定该技术是否具有临床益处。本研究的目的是进一步评估与传统tka相比,机器人辅助tka是否能改善住院患者的术后预后。材料和方法经IRB批准后,对100名机器人辅助初级TKA和100名接受常规TKA的匹配对照组进行回顾性图表审查。患者在2016年至2018年期间接受了原发性TKA,术后至少6个月由一名在大容量关节中心接受过培训的关节置换外科医生进行随访。排除标准包括40例。记录人口统计学和术后结果,包括住院时间(LOS)、阿片类药物消耗、阿片类药物使用持续时间和出院状况。结果两组术前人口统计学差异无统计学意义。与对照组相比,机器人TKA组的LOS (1.58 vs. 2.18天,p < 0.001)和吗啡当量(73.52 vs. 102.50, p = 0.017)下降。与对照组相比,机器人组术后6周需要阿片类药物的患者也较少(37对61,p = 0.001)。对照组术后6个月平均KOOS Jr为81.73,机器人组为78.22 (p = 0.039)。结论机器人辅助TKA患者术后6周的LOS、吗啡当量和阿片类药物使用显著降低,表明机器人辅助TKA具有早期临床益处。机器人组与对照组术前KOOS Jr无显著差异。尽管对照组术后6个月平均KOOS Jr略高,但差异无临床意义。两组患者的平均kos Jr均高于全国术后1年平均值76.8。
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